0001214659-17-005190.txt : 20170817 0001214659-17-005190.hdr.sgml : 20170817 20170817171840 ACCESSION NUMBER: 0001214659-17-005190 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170717 FILED AS OF DATE: 20170817 DATE AS OF CHANGE: 20170817 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CARLSON THOMAS J CENTRAL INDEX KEY: 0001135396 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTIONS, NOT FEDERALLY CHARTERED [6036] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18082 FILM NUMBER: 171039384 MAIL ADDRESS: STREET 1: 1414 N. BENTON AVE CITY: SPRINGFIELD STATE: MO ZIP: 65802 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GREAT SOUTHERN BANCORP INC CENTRAL INDEX KEY: 0000854560 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 431524856 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1451 E BATTLEFIELD CITY: SPRINGFIELD STATE: MO ZIP: 65804 BUSINESS PHONE: 417-887-4400 MAIL ADDRESS: STREET 1: P O BOX 9009 CITY: SPRINGFIELD STATE: MO ZIP: 65808-9009 4 1 marketforms-39469.xml PRIMARY DOCUMENT X0306 4 2017-07-17 0000854560 GREAT SOUTHERN BANCORP INC GSBC 0001135396 CARLSON THOMAS J 218 S. GLENSTONE AVE SPRINGFIELD MO 65802 true false false false Common stock 100 D Common stock 2017-07-17 5 J false E 61 52.23 A 13220 I Spouse Option to purchase 32.59 2024-10-15 Common stock 5000 5000 D Option to purchase 41.3 2026-10-24 Common Stock 2000 7000 D DRIP acquisition exempt from Section 16 reporting being reported voluntarily 1,250 shares vest on 10/15/2016, 10/15/2017, 10/15/2018 and 10/15/2019 500 shares vest on 10/24/2018, 10/24/2019, 10/24/2020 and 10/24/2021 Matt Snyder, Attorney-in-fact for Thomas J. Carlson 2017-08-17